C-reactive protein-triglyceride glucose index predicts stroke incidence in a hypertensive population: a national cohort study

Abstract Background Both the triglyceride-glucose (TyG) index, a predictor of insulin resistance (IR), and inflammation are risk factors for stroke in hypertensive patients. However, only a handful of studies have coupled the TyG index and inflammation indices to predict stroke risk in hypertensive...

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Main Authors: Songyuan Tang, Han Wang, Kunwei Li, Yaqing Chen, Qiaoqi Zheng, Jingjing Meng, Xin Chen
Format: Article
Language:English
Published: BMC 2024-11-01
Series:Diabetology & Metabolic Syndrome
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Online Access:https://doi.org/10.1186/s13098-024-01529-z
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author Songyuan Tang
Han Wang
Kunwei Li
Yaqing Chen
Qiaoqi Zheng
Jingjing Meng
Xin Chen
author_facet Songyuan Tang
Han Wang
Kunwei Li
Yaqing Chen
Qiaoqi Zheng
Jingjing Meng
Xin Chen
author_sort Songyuan Tang
collection DOAJ
description Abstract Background Both the triglyceride-glucose (TyG) index, a predictor of insulin resistance (IR), and inflammation are risk factors for stroke in hypertensive patients. However, only a handful of studies have coupled the TyG index and inflammation indices to predict stroke risk in hypertensive patients. The C-reactive protein-triglyceride-glucose index (CTI) is a novel marker that comprehensively assesses the severity of IR and inflammation. The present study explored the association between CTI and the risk of stroke in patients with hypertension. Methods A total of 3,834 hypertensive patients without a history of stroke at baseline were recruited from the China Health and Retirement Longitudinal Study (CHARLS). Multivariate Cox regression and restricted cubic spline (RCS) analyses were employed to assess the relationship between CTI and stroke risk in hypertensive patients. Furthermore, the Boruta algorithm was applied to evaluate the importance of CTI and construct prediction models to forecast the incidence of stroke in the study cohort. Results After 7 years of follow-up, the incidence of stroke in hypertensive patients was 9.6% (368 cases). Multivariate Cox regression analysis revealed a 21% increase in stroke risk with an increase in each CTI unit (hazard ratio (HR) = 1.21, 95% confidence interval (CI) = 1.08–1.37). The top quartile group was 66% more likely to have a stroke than the bottom quartile group (HR = 1.66, 95% CI = 1.23–2.25). RCS analysis confirmed a linear relationship between CTI and stroke risk. The Boruta algorithm validated CTI as a crucial indicator of stroke risk. The Support Vector Machine (SVM) survival model exhibited the best predictive performance for stroke risk in hypertensive patients, with an area under the curve (AUC) of 0.956. Conclusions An increase in CTI levels is associated with a higher risk of stroke in hypertensive patients. This study suggests that CTI may emerge as a unique predictive marker for stroke risk.
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spelling doaj-art-2136010224914075ba2bebba8431021a2024-11-24T12:36:51ZengBMCDiabetology & Metabolic Syndrome1758-59962024-11-0116111210.1186/s13098-024-01529-zC-reactive protein-triglyceride glucose index predicts stroke incidence in a hypertensive population: a national cohort studySongyuan Tang0Han Wang1Kunwei Li2Yaqing Chen3Qiaoqi Zheng4Jingjing Meng5Xin Chen6School of Life Science and Engineering, Affiliated Hospital of Southwest Jiaotong University, The Third People’s Hospital of ChengduDepartment of Cardiology, The Third People’s Hospital of ChengduSchool of Life Science and Engineering, Affiliated Hospital of Southwest Jiaotong University, The Third People’s Hospital of ChengduSchool of Life Science and Engineering, Affiliated Hospital of Southwest Jiaotong University, The Third People’s Hospital of ChengduSchool of Life Science and Engineering, Affiliated Hospital of Southwest Jiaotong University, The Third People’s Hospital of ChengduSchool of Life Science and Engineering, Affiliated Hospital of Southwest Jiaotong University, The Third People’s Hospital of ChengduSchool of Life Science and Engineering, Affiliated Hospital of Southwest Jiaotong University, The Third People’s Hospital of ChengduAbstract Background Both the triglyceride-glucose (TyG) index, a predictor of insulin resistance (IR), and inflammation are risk factors for stroke in hypertensive patients. However, only a handful of studies have coupled the TyG index and inflammation indices to predict stroke risk in hypertensive patients. The C-reactive protein-triglyceride-glucose index (CTI) is a novel marker that comprehensively assesses the severity of IR and inflammation. The present study explored the association between CTI and the risk of stroke in patients with hypertension. Methods A total of 3,834 hypertensive patients without a history of stroke at baseline were recruited from the China Health and Retirement Longitudinal Study (CHARLS). Multivariate Cox regression and restricted cubic spline (RCS) analyses were employed to assess the relationship between CTI and stroke risk in hypertensive patients. Furthermore, the Boruta algorithm was applied to evaluate the importance of CTI and construct prediction models to forecast the incidence of stroke in the study cohort. Results After 7 years of follow-up, the incidence of stroke in hypertensive patients was 9.6% (368 cases). Multivariate Cox regression analysis revealed a 21% increase in stroke risk with an increase in each CTI unit (hazard ratio (HR) = 1.21, 95% confidence interval (CI) = 1.08–1.37). The top quartile group was 66% more likely to have a stroke than the bottom quartile group (HR = 1.66, 95% CI = 1.23–2.25). RCS analysis confirmed a linear relationship between CTI and stroke risk. The Boruta algorithm validated CTI as a crucial indicator of stroke risk. The Support Vector Machine (SVM) survival model exhibited the best predictive performance for stroke risk in hypertensive patients, with an area under the curve (AUC) of 0.956. Conclusions An increase in CTI levels is associated with a higher risk of stroke in hypertensive patients. This study suggests that CTI may emerge as a unique predictive marker for stroke risk.https://doi.org/10.1186/s13098-024-01529-zStrokeC-reactive protein-triglyceride-glucose indexHypertensionInflammationInsulin resistance
spellingShingle Songyuan Tang
Han Wang
Kunwei Li
Yaqing Chen
Qiaoqi Zheng
Jingjing Meng
Xin Chen
C-reactive protein-triglyceride glucose index predicts stroke incidence in a hypertensive population: a national cohort study
Diabetology & Metabolic Syndrome
Stroke
C-reactive protein-triglyceride-glucose index
Hypertension
Inflammation
Insulin resistance
title C-reactive protein-triglyceride glucose index predicts stroke incidence in a hypertensive population: a national cohort study
title_full C-reactive protein-triglyceride glucose index predicts stroke incidence in a hypertensive population: a national cohort study
title_fullStr C-reactive protein-triglyceride glucose index predicts stroke incidence in a hypertensive population: a national cohort study
title_full_unstemmed C-reactive protein-triglyceride glucose index predicts stroke incidence in a hypertensive population: a national cohort study
title_short C-reactive protein-triglyceride glucose index predicts stroke incidence in a hypertensive population: a national cohort study
title_sort c reactive protein triglyceride glucose index predicts stroke incidence in a hypertensive population a national cohort study
topic Stroke
C-reactive protein-triglyceride-glucose index
Hypertension
Inflammation
Insulin resistance
url https://doi.org/10.1186/s13098-024-01529-z
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